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The Hill: Medicare’s broken pay formula threatens pathologists again

Release Date: 13 Apr 2023
Emily E. Volk, MD, FCAP

By Emily E. Volk, MD, FCAP; The Hill

Nearly everyone agrees Medicare’s payment system for physicians is broken. After years of Medicare cuts and temporary mitigating fixes by Congress, physicians face more decreases to the services they provide to seniors next year.  

Without additional relief, pathologists will receive a Medicare cut of 6.5 percent in 2024 despite the steadily increasing value of accurate and reliable diagnoses and clinical laboratory test results to patients. The reduction stems from a complex set of budgetary rules and systemic flaws within the Medicare physician fee schedule that, unless addressed, will continue to plague physicians for years to come. These include the budget-neutrality requirement for Medicare mandating that any increase for certain physician services must be offset by cuts elsewhere.  

Congress needs to act with short- and long-term measures to stabilize Medicare’s fee schedule and protect access to services by physicians in rural and urban settings.  

Margins at physician practices are extremely thin as inflationary pressures have increased costs in all sectors of the economy, including health care. Future cuts to Medicare reimbursement will only threaten the ability for some practices to stay open if rising costs exceed revenue.  

We have seen pressures faced by pathologists and the rest of the laboratory workforce increase throughout the pandemic. For pathologists, we are unique as our work touches every aspect of the health care continuum as we are the ones who diagnose the disease that patients are facing. 

Continue reading on thehill.com.

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